title: A comparison of bed rest and immersion for treating the edema of pregnancy.
abstract: Bed rest and immersion both lead to a mobilization of extravascular fluid and thus reduce edema. This study compared three treatments for edema in healthy pregnant women in the third trimester: lateral supine bed rest at room temperature, sitting in a bathtub of waist-deep water at 32 +/- 0.5C with legs horizontal, and sitting immersed in shoulder-deep water at 32 +/- 0.5C with legs extended downward. Post-treatment diuresis was selected as the indicator of extravascular fluid mobilization. The mean (+/- SD) diuresis was 105 +/- 48, 161 +/- 155, or 242 +/- 161 mL/hour for bed rest, bathtub, and immersion tank, respectively (P less than .008, tank versus bed rest; P less than .05, tank versus bath). In all treatments, mean arterial pressure (MAP) declined from a baseline value of 88 +/- 9 to 77 +/- 10 mmHg 25 minutes into treatment and 77 +/- 11 mmHg at 50 minutes (both P less than .0001 compared with pre-treatment). Shoulder-deep immersion produced the greatest decline in MAP. Sodium clearance increased from 0.7 to 1.0 mEq/minute in all treatments (P less than .01). Serum sodium, potassium, creatinine, osmolarity, total protein, 6-keto prostaglandin F1 alpha, and plasma volume did not change significantly after the treatments. Serum prolactin declined significantly from 137.8 +/- 44 to 124 +/- 31 ng/mL after treatment; there was no difference among treatments. Immersion appears to be a safe and more rapid method than bed rest to mobilize extravascular fluid during pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill.
authors.forename: V L
authors.initials: VL
authors.lastname: Katz
authors.forename: R M
authors.initials: RM
authors.lastname: Ryder
authors.forename: R C
authors.initials: RC
authors.lastname: Cefalo
authors.forename: S C
authors.initials: SC
authors.lastname: Carmichael
authors.forename: R
authors.initials: R
authors.lastname: Goolsby
mesh_terms: D000328:Adult; D001510:Bed Rest; D001794:Blood Pressure; D004231:Diuresis; D004487:Edema / Q000628:therapy*; D005260:Female; D006801:Humans; D007101:Immersion; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011263:Pregnancy Trimester, Third; D011388:Prolactin / Q000097:blood; D012964:Sodium / Q000378:metabolism
chemical_list: D011388:Prolactin; D012964:Sodium